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General NPI Number Information
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NPI Number | 1407380108
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Entity Type | Organization
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Legal Business Name | 2410 STILLHOUSE SENIOR LIVING, INC.
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 2410 STILLHOUSE RD
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City | PARIS
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State | TX
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Zip | 75462-2065
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Country | US
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Telephone | 903-784-8800
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Fax | 903-737-2964
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Provider Business Mailing Address
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Address Line | 2410 STILLHOUSE RD
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City | PARIS
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State | TX
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Zip | 75462-2065
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Country | US
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Telephone | 903-784-8800
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Fax | 903-737-2964
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Authorized Official
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Title or Position | SECRETARY
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Name | AMBER L TUELLER
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Credential |
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Telephone | 208-207-2726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | TX
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